Author Interviews, Compliance, Heart Disease / 13.11.2015
Medication Adherence Rates Vary Widely Across US Hospitals
MedicalResearch.com Interview with:
Dr. Tracy Wang MD MHS MSc
Assistant Dean, Continuing Medical Education
Director, Center for Educational Excellence
Fellowship Associate Program Director
Associate Professor of Medicine, Cardiology
Duke Clinical Research Institute
Medical Research: What is the background for this study? What are the main findings?
Response: Medication non-adherence is a known challenge in the management of patients with coronary artery disease. Barriers to adherence are multifactorial, attributed to patient, healthcare provider, and social determinants. However, whether patient medication adherence varies across different hospitals is unknown. In this study, we sought to determine whether inter-hospital differences exist in the degree of patient adherence to secondary prevention medications after discharge. Moreover, we assessed whether these hospital-specific variations in medication adherence, if any, correspond to downstream patient outcomes.
We observed that the majority of post-MI patients were prescribed guideline-recommended secondary prevention medications at discharge. However, among those prescribed, we see a significant decline in the use of these medications within just 90 days after discharge. Medication adherence rates varied markedly across U.S. hospitals, with the widest variation seen for post-discharge use of beta-blockers. Hospitals with high post-discharge medication adherence were associated with significantly lower risk of major adverse cardiovascular events and death or all-cause readmissions when compared with hospitals with low adherence rates, even after adjustment for differences in patient case-mix.
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